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In metaphyseal areas, delayed signs of fracture include a band of sclerosis perpendicular to the trabeculae, while diaphyseal fractures may present as periosteal thickening. [1] Digital radiography known as tomosynthesis has been shown to be superior to conventional radiographs in the detection of occult fracture of the scaphoid.
Fractures of the scaphoid are common in young males. [22] They are less common in children and older adults because the distal radius is weaker contributor to the wrist and more likely to fracture in these age groups. [7] Scaphoid fractures account for 50%-80% of carpal injuries. [8]
Anatomic illustrations of the wrist depicting the progressive stages of scapholunate advanced collapse. (A) Normal wrist demonstrating an intact scapholunate ligament (white arrowhead), normal scapholunate interval, and preservation of the joint spaces. (S = scaphoid, L = lunate, C = capitate, R = radius, U = ulna).
Scapholunate advanced collapse is the most common form, followed by scaphoid non-union advanced collapse (SNAC). [3] Other post-traumatic causes such as intra-articular fractures of the distal radius or ulna can also lead to wrist osteoarthritis, but are less common.
The scaphoid can be slow to heal because of the limited circulation to the bone. Fractures of the scaphoid must be recognized and treated quickly, as prompt treatment by immobilization or surgical fixation increases the likelihood of the bone healing in anatomic alignment, thus avoiding mal-union or non-union. [6] Delays may compromise healing.
Bone fractures, joint dislocations, high dose steroids [1] Diagnostic method: Medical imaging, biopsy [1] Differential diagnosis: Osteopetrosis, rheumatoid arthritis, Legg–Calvé–Perthes syndrome, sickle cell disease [3] Treatment: Medication, not walking on the affected leg, stretching, surgery [1] Frequency ~15,000 per year (US) [4]
Kienböck's disease is a disorder of the wrist.It is named for Dr. Robert Kienböck, a radiologist in Vienna, Austria who described osteomalacia of the lunate in 1910. [1]It is breakdown of the lunate bone, a carpal bone in the wrist that articulates with the radius in the forearm.
Chauffeur's fracture, also known as Hutchinson fracture, is a type of intraarticular oblique fracture of the radial styloid process in the forearm. [1] The injury is typically caused by compression of the scaphoid bone of the hand against the styloid process of the distal radius. It can be caused by falling onto an outstretched hand.